A new state-of-the art computed tomography (CT) scanner that provides physicians with precise images of internal organs with a single rotation of the gantry is now in operation at Stony Brook University Medical Center (SBUMC), adding to the hospital’s advanced scanner technology.

The Toshiba Aquilion ONE 320-detector row CT system with pediatric imaging capabilities is able to image an entire organ in a single rotation or over multiple rotations, showing real-time dynamic movement. The single rotation will result in lower doses of radiation, which is particularly important for children and teens, who are still developing.

"That's the age group for which you want to conserve radiation exposure," said Dr. Michael Poon, a world-renowned expert in cardiac CT and magnetic resonance imaging (MRI) and Director of the Advanced Cardiovascular Imaging Program for adult and pediatric patients. Dr. Poon developed the advanced technique for diagnosing cardiovascular problems using CT scanning that exposes patients to the equivalent of just two chest x-rays.

A typical CT scan exposes patients to the radiation equivalent of 200 x-rays. Dr. Poon has performed more than 1,000 cardiac CTA's (CT angiographies) within the past year at SBUMC and used the low-dose radiation technique for the first time on two pediatric patients.

"One of the kids was referred to me by a pediatric cardiologist because he suspected the patient had a congenital coronary anomaly. The only definitive noninvasive test to diagnose this condition is a cardiac CT, which he had been reluctant to use because of the radiation exposure. I was able to do the test in less than one minute, make a definitive diagnosis, and limit radiation exposure to this patient. As a result of getting the right diagnosis, we can treat this patient appropriately."
Dr. Poon points out that the addition of this new CT technology will help SBUMC physicians diagnose disease more safely for infants, children and adolescents because of the reduced radiation exposure. The technology will also help provide more flexibility in diagnosing many conditions of children and adults.

The new CT scanner will allow physicians to see not only a three-dimensional depiction of an organ, but also how the organ and blood flow are dynamically functioning or moving within and around the organ. No other CT system can do this. The Aquilion ONE can perform uniquely comprehensive exams, including functional studies, that can reduce overall healthcare costs by replacing the need for multiple tests and invasive procedures, while reducing the amount of contrast material and radiation dose. Additionally, multi-phase studies, such as perfusion of the brain, heart and other organs, are possible with the Aquilion ONE.

CT technology enables Dr. Poon and colleagues to view the entire structure of heart, the internal and external features, including the coronary vessels and structural components inside the heart, in order to diagnose cardiac disease or rule it out. The procedure is non-invasive, often leads to a definitive diagnosis, and prevents some patients from further non-invasive and invasive testings such as nuclear stress test, cardiac catheterization or coronary stenting.

Dr. Poon has pioneered many dose-saving methods to diagnose cardiovascular problems via CT scanning that use extremely low doses of radiation, thus drastically reducing risk of potential harmful effects from unnecessary high does or radiation exposure. Reduced radiation exposure is particularly important for younger patients and women. Dr. Poon is the only physician on Long Island and among the few in the country who employs such advanced dose-saving methods in all emergent and routine cardiac CT scans performed at SBUMC.

Advanced Cardiac Imaging with Low Dose Radiation – A Patient Story

Before SBUMC secured the 320 slice technology, a low dose, 64 slice advanced cardiac CT scan saved Joanne Bloomfield, 42, of Port Jefferson, from what doctors told her could have been 2-3 months of additional testing. Ms. Bloomfield entered the hospital in January 2009 with dangerously high blood pressure and a long history of chest pains and blackouts. Doctors used a low dose CT scan to rule out cardiac problems as a cause of her symptoms. This helped lead them to the conclusion that her symptoms were brought on by other conditions, mainly ones associated with autoimmune abnormalities.

"That CT scan was a turning point in my life. They gave me medicine to reduce my blood pressure and other symptoms, and I was better within a week," she said. "It was amazing. My life today is utterly different. I believe that the fact that the CT scan was available made an enormous difference in my life. The care I got at Stony Brook was stellar, and the cardiology care I received has changed my life. I'm on my way to being dangerously healthy."

Dr. Poon's work with CTA, as well as other emerging, versatile, and powerful cardiac imaging technologies – such as cardiac MRI and stress testing with MRI, which requires no exposure to radiation or kidney-toxic contrast agent, and takes less time to perform and complete than a standard ECG or nuclear stress test – has been critical in diagnosing conditions ranging from congenital heart disease, ischemic heart disease, congestive heart failure, heart murmurs, to various types of vascular aneurysms and complex cardiovascular diagnostic challenges.

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